state laws. The lack of professional standards nationwide is problem brought to APNs for the
nursing profession. Registered nurses (RN) are regulated from state to state as well, and this
archaic process seems to be infiltrated into the APN profession. States holding different practice
guidelines for APNs reimbursement needs to be address with the Institute of Medicines (IOM)
recommendations in Congress with the implication of the Affordable Care Act (ACA) in mind.
Even with the nursing profession having the most trusted professionals in the health care
field, there is a lot of resistance to APNs practicing with complete authority. As